AB0937 Improvement in clinical disease activity and no deterioration in quality of life in psoriatic arthritis patients followed for 5 years in a Norwegian outpatient clinic.
Authors: M. Wilk, S. Brådland, B. Michelsen, M. Korkosz, G. Haugeberg
Journal: Annals of the Rheumatic Diseases (2022)

Background Recent years of progress in conventional and biologic disease-modifying anti-rheumatic drugs development and improved treatment strategies (treat to target) have yield in improved outcome in psoriatic arthritis (PsA) patients. [1,2]. Still, despite modern treatment and clinical monitoring methods, we might miss dimensions of disease burden outside our main focus including quality of life (QoL), which are of high importance from patients’ perspective. Objectives Main objective of this study was to explore how clinical aspects of disease activity and QoL measures will change in PsA patients in an ordinary outpatient clinic in Norway, followed for 5 years, in the biological treatment era. Methods PsA patients fulfilling the CASPAR criteria visiting an outpatient clinic in Norway between January 2013 and February 2020 were consecutively included in the study. Data collection included variables for demographics, treatment, laboratory assessment of ESR and CRP, joint counts, disease activity score in psoriatic arthritis (DAPSA), global assessments – patient’s (PGA) and investigator’s (IGA), reported joint and global pain, patient reported outcomes (PROMs) regarding different aspects of quality of life (QoL), (MHAQ, RAID, QoL15D and reported fatigue level). Patients were analyzed at baseline and after 5-year follow-up period. Statistics included paired sample t test and McNemar test. Results Among 140 PsA patients included at baseline, 114 (81.4%) were re-examined after 5 years. Mean age at baseline was 52 years (95%CI 50.3-53.7) and percentage of women was 50.7%. Proportion of patients treated with biologics increased from 32.9% to 39.5%, but the difference wasn’t statistically significant. During the 5 year follow up period most clinical disease activity measures decreased and QoL was maintained (Table 1). Table 1. Demographic data, clinical activity measures and patient reported outcomes regarding quality of life in PsA patients followed for 5 years. Values are mean (95CI) or number (%). Baseline (140 ) 5-years follow up (114 ) p Age (years) 52.0 (50.3, 53.7) 56.3 (54.4, 58.3) Women 71 (50.7%) 56 (49.1%) Exercise &gt;1h week 62 (44.3%) 59 (51.8%) 0.28 BMI (kg/m2) 28.4 (27.5, 29.2) 28.2 (27.3, 29.1) 0.89 Current smoker 24 (17.1%) 17 (14.9%) 0.90 Current bDMARD treatment 46 (32.9%) 45 (39.5%) 0.65 DAPSA 18.6 (16.2, 21.0) 12.8 (10.8, 14.8) &lt;0.01 TJC68 4.1 (3.2, 5.0) 1.8 (1.3, 2.4) &lt;0.01 SJC66 0.7 (0.5, 0.9) 0.3 (0.2, 0.4) &lt;0.01 ESR 15.9 (13.9, 18.0) 10.7 (7.8, 13.5) &lt;0.01 CRP 4.9 (3.5, 6.3) 5.3 (2.5, 8.2) 0.41 IGA (VAS 0-100) 4.1 (3.2, 5.0) 1.8 (1.3, 2.4) &lt;0.01 PGA (VAS 0-100) 36.6 (32.5, 40.8) 29.3 (25.0, 33.6) 0.12 Global pain (VAS 0-100) 35.1 (31.2, 39.0) 28.9 (24.4, 33.5) 0.42 Joint pain (VAS 0-100) 33.8 (29.9, 37.8) 27.5 (23.2, 31.9) 0.31 MHAQ (0-3) 0.4 (0.4, 0.5) 0.3 (0.3, 0.4) 0.72 RAID (0-10) 3.5 (3.1, 3.9) 3.2 (2.9, 3.6) 0.41 QoL15D (15-75) 24.2 (23.1, 25.2) 22.7 (21.6, 23.9) 0.85 Fatigue (VAS 0-100) 47.8 (41.5, 54.2) 39.1 (32.8, 45.4) 0.16 Conclusion In our cohort of PsA patients after 5 years follow up disease activity was reduced and QoL maintained. Our data adds to the evidence that the burden of disease in PsA patients has decreased in the biologic treatment era however is still significant. Further improvement in pharmacological and non-pharmacological treatments in PsA patients is still needed. References [1]Coates LC, Moverley AR, McParland L, et al. Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet. 2015;386(10012):2489-2498. doi:10.1016/S0140-6736(15)00347-5 [2]Coates LC, Helliwell PS. Treating to target in psoriatic arthritis: how to implement in clinical practice. Ann Rheum Dis. 2016;75(4):640-643. doi:10.1136/annrheumdis-2015-208617 Acknowledgements Nurses and doctors from Division of Rheumatology at Sørlandet Hospital in Kristiansand, Norway contributed to data collection. Disclosure of Interests None declared